Thandeka Moyo Bulawayo Bureau
About 20 percent of Zimbabwean births over the past five years occurred at home, statistics which experts have described as unacceptably high.
According to the recently-released Zimbabwe Demographic Health Survey (ZDHS), institutional deliveries stood at an average of 77 percent.
“Seventy-seven percent of live births in the five years before the survey took place in a health facility, while 20 percent were delivered at home. Most institutional deliveries took place at public sector health facilities,” reads the report.
“In Zimbabwe, institutional deliveries declined from 72 percent in 1999, to 68 percent in 2005-06, and 65 percent in 2010-11, and then substantially increased to 77 percent in 2015.
“Over the same period, home deliveries increased from 23 percent in 1999, to 31 percent in 2005-06, and 34 percent in 2011-10, and then decreased notably to 20 percent in 2015.”
The report shows that Bulawayo and Harare provinces had the most institutional births at about 91 percent. Midlands, Matabeleland South and Matabeleland North had high percentages ranging from 81 to 85 percent.
“Masvingo and Mashonaland East had institutional deliveries ranging from 71- 80 percent. Mashonaland West, Mashonaland Central and Manicaland recorded the least institutional births, ranging from 66 to 70 percent.”
Gender activist Ms Lindile Ndebele said the decline in home deliveries to 20 percent could not be celebrated as it indicated that many women were still at risk of maternal deaths.
“The decrease does not bring any good news because 20 percent is still a high number given our high maternal mortality rate,” she said. “This shows that women are still failing to access healthcare generally due to financial constraints, long distances for those in rural areas and other issues.”
The World Health Organisation defines maternal mortality as the death of a woman while pregnant or within 42 days of termination of pregnancy, irrespective of the duration and site of the pregnancy, from any cause related to or aggravated by the pregnancy or its management, but not from accidental or incidental causes.
According to the 2014 Multiple Indicator Cluster Survey (MICS), Zimbabwe’s maternal mortality rate stands at 614 deaths per every 100 000 live births and haemorrhaging has been identified as the leading cause of maternal death.
The United Nations Population Fund considers a maternal mortality ratio of less than 100 as low, between 100 and 299 as moderately low, and high when it is 300 to 499.
Ms Ndebele said women sometimes avoid health institutions fearing detention after failing to clear hospital arrears.
“As a country we have 2030 HIV targets that we want to reach, but if 20 percent of pregnant women don’t have access to prevention of mother to child transmission (PMTCT), we are bound to lose that battle,” she said.
“There is need to raise awareness and come up with policies that will ensure that women choose health institutions as the safest and convenient places of delivery.”
The ZDHS shows that births to mothers with more than a secondary education are much more likely to take place in a health facility than births to mothers with no basic education.